Provider Demographics
NPI:1306952544
Name:DARIN, FREDERICK PETER (OD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:PETER
Last Name:DARIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 LANSING ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1696
Mailing Address - Country:US
Mailing Address - Phone:517-543-2020
Mailing Address - Fax:517-543-0311
Practice Address - Street 1:123 LANSING ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1696
Practice Address - Country:US
Practice Address - Phone:517-543-2020
Practice Address - Fax:517-543-0311
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
410029435OtherMEDICARE RAILROAD
MIFD002253OtherBCBS
410029435OtherRAILROAD MEDICARE
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MI1039600001Medicare NSC
MIFD002253OtherBCBS
T32724Medicare UPIN